December 2018
Newsletter

The famous Alma-Ata Declaration of 1978 had emerged as a major milestone of the twentieth century in the field of public health, and it identified primary health care as the key to the attainment of the goal of Health for All.

As a follow-up to the Alma-Ata declaration, the Declaration of Astana which has just been published (25, 26 October 2018) includes palliative care as a part of primary health care for Universal Health Coverage (UHC).

We offer patients free palliative care as well as free medicines. For families who are struggling to put food on the table, we provide food packets. We also support the education of the kids in the suffering families.

Pallium India works only on donations.

To continue our work with patients and families, and to stop their suffering, we need money. With your kind help, we will be able to save lives, educate children and prevent these families from being destroyed.

On 28 & 29 October, we conducted a two-day workshop at Sahodaran Community Oriented Health Development (SCOHD), Puducherry, to understand and address the needs of transgenders, and to introduce the concepts of palliative care among them. The workshop is a step towards ensuring we’re “leaving no one behind”.

I would like to share an experience from the workshop, that touched me deeply. The group that came on the second day was older than the group that came on the first day. It was difficult for them to open up and their problems were different from that of the first group. When we started the group discussion, I joined a team of eight members. They talked about discrimination, stigma and accessibility issues. But the person who sat near me, well dressed in a saree and who appeared to be healthy, said, “I am all alone at home. I do not have anybody with me, for me to take care of or to take care of me. People including health care professionals approach us with hatred. If you get a wound, you bleed red, I too bleed red and not green; and then why should you see us differently? We are also human beings. I am HIV positive, I am taking medicines, and all that I get from the ration shop is a fixed quantity of rice and nothing else. I get a small pension and that’s how I survive.”

This is not the only story that I wish to narrate, but this is the shortest. Everyone had similar experiences. Loneliness, hopelessness and substance abuse were explicit among the group.

Friends, it is high time for us to realize that health care, including palliative care, must reach every human being in serious health related suffering irrespective of their gender or sexual orientation – they too bleed red, just as we do. Let me remind you that the 2017 Lancet Commission Report on Palliative Care mentions the need to develop access to mental health professionals. Literature review suggest that LGBTQI are at high risk of depression, anxiety, substance abuse and suicidal tendencies. This is the reason that Dr Seema Rao, an expert both in palliative care and psychiatry, has joined us as our resource person. At the workshop, we listened to only about sixty out of the 487,803 LGBTQI people (Census 11) in our country. Let us try to listen to each one of them and understand their needs.

Pallium India’s new facility at PMS Dental College Campus, Vattappara, Thiruvananthapuram, was inaugurated by Shri Kadakampally Surendran, state minister for Co-operation, Tourism and Devaswom, on November 21, 2018.

29 November 2018 saw a whole day’s pre-conference workshop dedicated to palliative care at Ahmedabad, prior to the National Conference on Pulmonary Diseases. As Dr Rajani Surendar Bhat pointed out quoting Victor Hugo, “Nothing can stop an idea whose time has come”. It now appears that palliative care has indeed arrived at the Pulmonary Medicine Fort.

Dr Sujeet Rajan and Dr Rajam Iyer, two pulmonologists from Mumbai took the lead in organizing a whole-day pre-conference workshop on palliative care.

The famous Dr David Currow (seen in the picture) from Australia was the star attraction.

There were talks, a panel discussion and role plays. All in all, a very satisfying day. Pallium India was privileged to be a part of it.

The film will be followed by an audience interaction led by Dr. M. R. Rajagopal (Chairman of Pallium India and 2018 Padmashree Awardee).

This film has successfully toured India, the US, Australia and Canada, shining a light on health equity in developing countries; palliative care in India and the ethical practice of medicine. It has also served as a platform for creating more conversations around access to, and availability of pain relief, and to demand a health care system that treats the person and not just the disease.

In what we see as an exciting positive development, our internet-based ECHO (Extension for Community Healthcare Outcomes) educational program is being successful in empowering health care professionals from all over the country. We have already completed 5 different ECHO courses, some with as many as 22 leading spokes. We are immensely grateful to Dr Sanjeev Arora, the pioneering founder of ECHO International who agreed to work with us and to build our capacity.

The famous Public Health Foundation of India (PHFI) directed by Dr Srinath Reddy has taken over the task of evaluation of ECHO-India.

On the 27th of November 2018, we had representatives from both ECHO-India and PHFI on their evaluation visits. For us in Pallium India, it was a great learning experience.

The 26th International Conference of Indian Association of Palliative Care – IAPCONKochi2019 – will be held on 8th, 9th and 10th February 2019 (with a Pre-Conference Workshop on 7th February 2019) at AELI Hills, Keezhmadu, Aluva, Ernakulam, Kerala, India.

The Conference theme “Voices in palliative care; ensuring quality, creating solutions” centres around the core palliative care attitude of listening…to those living with serious health-related suffering and their families, to our communities, to our palliative care teams, to global palliative care advocates and to our policy and academic leaders.

A public interest litigation (PIL) was filed before the Madurai bench of the Madras high court seeking directions to the government to constitute palliative care centres in all government medical college hospitals, district headquarters and taluk hospitals.

The petitioner, P Prabhakar Pandian, an advocate stated that in Tamil Nadu, no palliative care units are available to the poor people, especially in rural areas. According to the petition, palliative care requires broad multi-disciplinary approach which includes good infrastructure and governance policy.

“It is an elephant in the room that we can no longer ignore – 55 million people in our country are victims of catastrophic health expenditure every year. Paying for health services pushes them into poverty. Children drop out of school, people lose their jobs and the ripple effect continues long after the patient is gone. India is somewhere near the bottom in the list of countries that have quality health care. But that need not be so. Palliative Care can reach hundreds and thousands of homes at very little cost,” says Dr Rajagopal in this interview with Democracy News Live.

Dr Suresh Reddy, Professor of palliative medicine at the famous MD Anderson Cancer Centre, Houston, Texas, has been our fellow traveller in the Palliative care movement in India. He has worked tirelessly, helping us to refine our educational programs, with advocacy and by raising resources. Proud of you dear Dr Suresh Reddy.

Dec 5, 2018: Screening of “Hippocratic”, the documentary film by Moonshine Agency, at St. Johns National Academy of Health Sciences, Bengaluru, as part of the National Bioethics Conference. Contact: vyshnavi@palliumindia.org

Feb 8, 9, 10, 2019: The 26th International Conference of Indian Association of Palliative Care – IAPCONKochi2019 – will be held on 8th, 9th and 10th February 2019 (with a Pre-Conference Workshop on 7th February 2019) at AELI Hills, Ernakulam, Kerala, India. Conference website: http://www.iapconkochi2019.com/ Last date to submit abstracts: Dec 30, 2018

Contact Pallium India’s Information Centre (9 am to 5 p.m., except on Sundays and National holidays) for information related to palliative care and about establishments where such facilities are available in India.

Disclaimer: Information provided by Pallium India has been collected from different sources and though every effort has been made to ensure that it is up-to-date, its accuracy cannot be assured. Pallium India shall have no liability for any damages, loss, injury, or liability whatsoever suffered as a result of reliance on the information provided.